Clinical, Cosmetic and Investigational Dermatology最新文献

Vitiligo is a common acquired depigmentation skin disease with obvious family aggregation. About 25-50% of patients have positive family history, which belongs to polygenetic disease. In recent years, through candidate genes and genome-wide association studies, multiple susceptibility gene loci have been found, and studies also show that there is genetic heterogeneity among different populations. Environmental factors can also interact with genetic factors to trigger diseases through various mechanisms. The risk assessment model based on genetic and environmental factors provides a new direction for early screening and personalized prevention and treatment. In the future, we need to combine single cell sequencing and other multi omics technologies to explore the mechanism, develop targeted treatment strategies, and strengthen the application of genetic counseling and preventive measures in high-risk populations.

Purpose: Pruritus is a common and distressing symptom among older adults, yet long-term patterns and regional differences across Europe remain insufficiently characterized. As European populations age rapidly, understanding how the burden of pruritus has evolved and may change is essential for clinical and public health planning.

Methods: Using Global Burden of Disease (GBD) 2023 estimates, we quantified incidence, prevalence, and disability-adjusted life years (DALYs) of pruritus among adults aged over 60 years in Central, Eastern, and Western Europe from 1990 to 2023. Age-standardized rates and case numbers were extracted for 5-year age groups by sex and country. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Future burden to 2050 was projected with Bayesian age-period-cohort models using Integrated Nested Laplace Approximation. All estimates included 95% uncertainty intervals.

Results: From 1990 to 2023, age-standardized incidence, prevalence, and DALY rates increased significantly across all three European regions. In 2023, Central Europe exhibited the highest rates, whereas Western Europe had the largest absolute numbers of affected individuals. Females consistently showed higher rates and earlier peak ages than males. Age-specific curves demonstrated an inverted-U shape, and country rankings were generally aligned with long-term EAPC patterns. Projections suggest continued growth in incident and prevalent cases and DALYs through 2050, especially in Western Europe, with persistent sex- and age-related disparities.

Conclusion: The burden of pruritus among older adults in Europe has risen steadily over the past three decades and is projected to increase further. Integrating routine itch assessment, optimized skin care, medication review, and strengthened referral pathways into primary, geriatric, and long-term care services is urgent to mitigate preventable disability in aging populations.

Background: Rosacea presents with visible symptoms and subjective symptoms like burning and itching; among these, burning may seriously impairs patients' quality of life. Current research has focused primarily on visible manifestations, with insufficient attention given to studying subjective symptoms such as burning. The aim of this study is to investigate the characteristics of burning, as well as the potential changes in facial blood flow of patients.

Methods: A questionnaire survey and retrospective study were employed. 177 patients answered questions related to their burning sensation. Laser speckle contrast imaging was used to investigate the differences in facial blood perfusion.

Results: Among 177 patients, 87.0% reported that the subtype of rosacea associated with burning was ETR, 58.8% experienced burning before their diagnosis, and the most commonly associated symptom was exacerbated erythema (85.3%). Dietary habits and behavioural practices can trigger burning. The onset of burning exhibits a certain seasonality, being most prevalent in winter (December, January, and February), and it is more likely to occur in the afternoon and during significant temperature fluctuations. Among five groups of patients matched by baseline characteristics and disease severity, four groups displayed higher facial blood perfusion in burning patients compared to non-burning patients within the same timeframe.

Conclusion: Burning sensation can be influenced by specific dietary or lifestyle habits and changes in external temperature. Burning may be related to increased facial blood perfusion.

Background: Extramammary Paget Disease (EMPD) is a rare intra-epithelial malignancy often misdiagnosed due to diverse clinical manifestations. This study retrospectively analyzed the clinicopathological features of 40 EMPD patients to provide references for clinical practice.

Methods: Clinical data of 40 patients with pathologically confirmed EMPD were collected, including demographics, clinical features, histopathological and immunohistochemical findings, treatments, and follow-up outcomes.

Results: Of the 40 patients (27 males, 13 females; mean age 68.8 years), the most common onset location was the external genitalia (n = 33). Lesions primarily presented as erythema or red plaques (n = 38), with itching being the most common symptom (n = 26). Immunohistochemically, tumor cells were positive for CK7, CEA, and EMA, with positive rates of 70% for GCDFP-15 and 25% for CK20. Thirty-nine patients underwent surgical excision, and one received photodynamic therapy combined with radiotherapy. During follow-up after surgery, one patient with invasive features (tumor mass in the dermis) recurred but achieved remission after reoperation; the other 38 patients remained disease-free. Invasive EMPD was associated with a higher risk of recurrence.

Conclusion: EMPD's varied presentations pose diagnostic challenges. Key diagnostic differentials include eczema, psoriasis, and melanoma, particularly for rare pigmented or depigmented variants. For clinicians, a high index of suspicion and prompt biopsy are crucial for early diagnosis. For pathologists, a comprehensive immunohistochemical panel is essential, while CK20's utility in distinguishing primary from secondary disease is limited and warrants further malignancy screening. Surgical excision remains the primary treatment, with alternative therapies effective for inoperable cases. Early diagnosis, appropriate treatment, and long-term follow-up are crucial for optimal prognosis.

Hair transplantation is a prolonged microsurgical procedure involving thousands of repetitive implantation movements performed under high magnification. In this setting, small ergonomic inefficiencies and orientation errors may accumulate over time, potentially affecting procedural flow, operator fatigue, and consistency of graft placement. While sharp implanters are widely used in contemporary hair transplantation, many existing designs primarily emphasize mechanical sharpness, loading capacity, or implantation speed, with comparatively limited attention paid to human-factor engineering during prolonged implantation. This study describes a human-factor-driven methodology for sharp implanter design, focusing on three core principles: error visibility, redundant orientation guidance, and workflow continuity. The proposed design integrates visual, tactile, and mechanical cues to facilitate rapid size recognition and consistent bevel orientation under magnification. Structural features are incorporated to reduce unintended component loosening and to enable one-touch modular disassembly for efficient needle exchange. Rather than demonstrating clinical superiority, this methodology presents a system-level design framework intended to support consistency, efficiency, and ergonomic stability during prolonged hair transplantation procedures.

Purpose: Rosacea is a long-term skin condition that causes redness and irritation on the face and is often accompanied by emotional challenges such as anxiety and depression. This study aimed to investigate the prevalence of depression and anxiety in patients with rosacea and examine their impact on quality of life, aiming to provide a basis for comprehensive clinical evaluation of the physical and psychological harm caused by the disease and for targeted treatments.

Methods: A total of 209 patients with rosacea who received treatment and the control group comprised 163 patients with isolated plantar warts. Depression, anxiety, and quality of life were assessed using the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Dermatology Life Quality Index (DLQI). Group differences were made using t-tests and χ ²-tests, and logistic regression was employed for association analysis.

Results: Patients with rosacea had significantly higher mean scores for depression, anxiety, and quality of life impairment than controls (P < 0.05). The proportions of patients with mild to severe depression, anxiety, and significant quality of life impairment were also higher in the rosacea group, with statistically significant differences (P < 0.05). Among patients with rosacea, both mild and moderate-to-severe depression and anxiety were associated with an increased risk of severe quality of life impairment (P < 0.05). Furthermore, joint effect analysis showed that patients with both depression and anxiety had a markedly higher risk of severe quality of life impairment compared with those without either condition (P < 0.05).

Conclusion: Rosacea is strongly associated with depression and anxiety, whose coexistence confers the greatest risk of quality-of-life impairment. Incorporating psychological screening and care into routine management may improve patient outcomes.

Radiation-induced alopecia (RIA) is an uncommon complication associated with fluoroscopy-guided neurointerventional procedures. We present a case of a 7-year-old female child who developed a well-demarcated square alopecic patch on the occipital scalp 18 days after undergoing intracranial vascular malformation embolization. Dermoscopic examination revealed multiple characteristic findings, including black dots, yellow dots, Pohl-Pinkus constrictions, tapered hairs, flame hairs, and upright regrowing hairs. The geometric shape of the alopecic patch was completely consistent with the intraoperative radiation exposure field, confirming the diagnosis of RIA. Notably, the presence of Pohl-Pinkus constrictions and tapered hairs suggests a dystrophic anagen response pattern, reflecting a less severe form of follicular damage that permits eventual hair regrowth. This case underscores the diagnostic value of dermoscopy in differentiating RIA from other common alopecic disorders, particularly in pediatric patients who have undergone neurointerventional procedures.

Purpose: As demand for nonsurgical aesthetic procedures increases, interest is also growing for desirable skin quality-radiant, healthy, and glowing skin-by patients seeking treatment to improve appearance. Although aesthetic medicine physicians are well positioned to advise on the role of basic skin care products in maintenance of results and healing, clear guidelines and protocols are currently lacking regarding the standard use of these products before and after aesthetic procedures.

Methods: An international panel of dermatologists (n = 6) and plastic surgeons (n = 2) convened virtually in March 2022 to discuss the role of skin care before and after nonsurgical aesthetic procedures (including injectables, energy-based devices, chemical peels, and microdermabrasion). As an outcome of that meeting, expert recommendations were developed for periprocedural skin care with the goal of improving recovery time or treatment outcomes for each procedure based on clinical evidence from a systematic literature review of relevant articles published through June 2022 combined with the authors' experience.

Results: Overall, 104 publications were identified and reviewed; publications could be counted more than once if they covered more than one topic (energy-based procedures, n = 70; injectable procedures including microneedling, n = 25; chemical peels, n = 21; microdermabrasion, n = 10). Common periprocedural skin care included daily routines utilizing cleansers, moisturizers, toners, hydroquinone, antioxidant serums, and sunscreens (as needed) across procedure types. Evidence supports pre/post-procedure routines (cleansers, moisturizers, toners, hydroquinone, antioxidants, sunscreens) across injectables (n = 25 studies), energy devices (n = 70), peels (n = 21), microdermabrasion (n = 10); high-evidence data limited, petrolatum/antioxidants show particular benefit post-laser.

Conclusion: Panel consensus endorses tailored regimens to optimize recovery/outcomes. However, very few studies were designed to evaluate a specific routine vs no skin care treatment. Further studies are needed to provide clinical evidence supporting the effectiveness of periprocedural skin care in reducing healing time and improving aesthetic outcomes. Herein, we provide evidence- and expert-based recommendations for incorporating daily skincare, including cleansers, moisturizers, antioxidant serums, depigmenting agents, and sunscreens, into periprocedural care for minimally invasive aesthetic treatments. These regimens should be adapted to procedure type and individual post-procedural responses and symptoms to optimize outcomes and address specific patient needs.

Purpose: Skin and subcutaneous diseases were the third most common global condition and the eighth leading cause of non-fatal health burden in 2021. Despite their high prevalence and substantial impact on quality of life, they remain relatively underprioritized in public health policy. This study aimed to examine long-term global trends and regional disparities in the burden of inflammatory and infectious skin diseases from 1990 to 2021.

Patients and methods: We conducted a cross-sectional analysis using data from the Global Burden of Disease (GBD) Study 2021. Age-standardized incidence rates, years lived with disability (YLDs), and average annual percentage change (AAPC) were assessed across 204 countries and territories, 21 global regions, and all age groups.

Results: In 2021, skin and subcutaneous diseases ranked as the eighth leading cause of YLDs worldwide. Between 1990 and 2021, inflammatory skin diseases demonstrated a modest increase in incidence (AAPC 0.08%) and YLDs (0.04%). Infectious skin diseases showed a slightly greater rise in incidence (0.19%), whereas YLDs declined marginally (-0.01%). The burden varied markedly by sociodemographic index (SDI) level and age, with the greatest impact observed among individuals younger than 20 years.

Conclusion: Inflammatory and infectious skin diseases exhibit distinct global trajectories and disproportionate burdens across regions and age groups. These findings highlight the importance of context-specific prevention strategies, improved equity in health service delivery, and greater policy prioritization of skin disease management in global and national health agendas.

Purpose: Melasma is a facial pigmentary disorder that commonly causes psychosocial distress. Quality of life (QoL) is not routinely assessed in daily practice; therefore, its improvement in relation with the reduction of melasma severity remains unclear, especially among people of color. This study aimed to determine whether clinical improvement after triple combination cream (fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05%) correlated with improved QoL.

Patients and methods: Participants with melasma were enrolled in a one-group pretest-posttest study and treated with triple combination cream for 12 weeks. The Melasma Quality of Life Scale (MELASQoL-INA, a validated questionnaire adapted into the Indonesian language) and the modified Melasma Area and Severity Index (mMASI) assessments were carried out at baseline visit and at weeks 4, 8, and 12 to evaluate QoL and clinical severity.

Results: Thirty female participants aged 30-60 years, with Fitzpatrick skin type IV or V and without other facial skin conditions, completed the study. The most negatively affected QoL domains were emotional well-being (appearance concerns, embarrassment, and frustration) and social life (desire to interact with other people). Significant improvements were observed in both mMASI (median reduction from 4.45 to 1.80; p < 0.001) and MELASQoL-INA scores (median reduction from 37 to 17; p < 0.001) after 12 weeks of treatment. Although no correlation was observed between mMASI and MELASQoL-INA scores at week 12 (r = 0.029, p = 0.879), a weak positive correlation was found between their respective changes after treatment (r = 0.397, p = 0.03).

Conclusion: Clinical improvement in melasma severity following triple combination therapy is modestly associated with improved QoL. However, QoL impairment does not always correspond linearly with disease severity, highlighting the importance of integrating subjective QoL outcomes alongside clinical evaluations in the management of melasma.